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Acute Kidney Insufficiency

Carlos A Hinojosa, Javier E Anaya-Ayala, Myriam Carrera-Ramirez, Paula Leal-Anaya, Ramón García-Alva, Rodrigo Lozano-Corona
Background: To analyze the factors that influence the deterioration of postoperative renal function in patients undergoing open or endovascular aortic reconstruction, and the impact on survival. Method: Retrospective review of patients who underwent invasive treatment was conducted. Demographics, laboratory data, clinical, intraoperative and postoperative variables were recorded; renal function was determined, Fisher's exact test was used to find associations and Kaplan Meier analysis to estimate survival...
2019: Cirugia y Cirujanos
Shuo-Fang Ren, Hong Yu, Ying-Qiang Guo, Hai Yu
INTRODUCTION: Many studies have found that volatile anesthetics are associated with improved clinical outcomes for adults undergoing coronary artery bypass grafting. However, the effect of volatile anesthetics for adults after heart valve surgery has been unclear. So we conducted a meta-analysis of randomized controlled trials (RCTs) to explore whether the choice of an anesthetic regimen might influence patients' outcomes after valve surgery. EVIDENCE ACQUISITION: PubMed, Embase, and Cochrane Library were searched from inception to June 2018...
February 13, 2019: Minerva Anestesiologica
Hiroyuki Yamada, Kent Doi, Tatsuo Tsukamoto, Hideyasu Kiyomoto, Kazuto Yamashita, Motoko Yanagita, Yoshio Terada, Kiyoshi Mori
BACKGROUND: Theoretically, atrial natriuretic peptide (ANP), especially low-dose ANP, is beneficial in acute kidney injury (AKI). In this study, we examined whether low-dose ANP is effective in preventing or treating AKI by conducting an updated systematic review for randomized controlled trials (RCTs). METHOD: We searched the Excerpta Medica database (EMBASE), PubMed, and Cochrane CENTRAL databases for RCTs that compare the effects of low-dose ANP (≤ 50 ng/kg/min) with a placebo or conventional therapy in at-risk patients or patients with AKI...
February 11, 2019: Critical Care: the Official Journal of the Critical Care Forum
Morcos Atef Awad, Lawrence S C Czer, Dominic Emerson, Stanley Jordan, Michele A De Robertis, James Mirocha, Evan Kransdorf, David H Chang, Jignesh Patel, Michelle Kittleson, Danny Ramzy, Joshua S Chung, J Louis Cohen, Fardad Esmailian, Alfredo Trento, Jon A Kobashigawa
Background Combined heart and kidney transplantation ( HKT x) is performed in patients with severe heart failure and advanced renal insufficiency. We analyzed the long-term survival after HKT x, the influence of age and dialysis status, the rates of cardiac rejection, and the influence of sensitization. Methods and Results From June 1992 to December 2016, we performed 100 HKT x procedures. We compared older (≥60 years, n=53) with younger (<60 years, n=47) recipients, and recipients on preoperative dialysis (n=49) and not on dialysis (n=51)...
February 19, 2019: Journal of the American Heart Association
Tong Chen, Peng-Cheng Xu, Shui-Yi Hu, Tie-Kun Yan, Jian-Qing Jiang, Jun-Ya Jia, Li Wei, Wen-Ya Shang
RATIONALE: Angiotensin receptor blocker (ARB) can increase serum creatinine or potassium levels in patients with renal insufficiency, renal artery stenosis, heart failure or hypovolemia, but hardly cause severe kidney injury in patients without any risk factors. A case of severe acute interstitial nephritis (AIN) induced by valsartan was reported here. PATIENT CONCERNS: A 62-year-old female with nausea for 1 month and acute deterioration of kidney function for 2 weeks was admitted...
February 2019: Medicine (Baltimore)
Evan R Zynda, Mitchell H Maloy, Eugene S Kandel
Kidney ischemia, characterized by insufficient supply of oxygen and nutrients to renal epithelial cells, is the main cause of acute kidney injury and an important contributor to mortality world-wide. Earlier research implicated a G-protein coupled receptor (NK1R) in the death of kidney epithelial cells in ischemia-like conditions. P21-associated kinase 1 (PAK1) is involved in signalling by several G-proteins. We explored the consequences of PAK1 inhibition for cell survival under the conditions of reduced glucose and oxygen...
February 6, 2019: Cell Cycle
Andrew G Wu, Uzma Samadani, Tina M Slusher, Lei Zhang, Andrew W Kiragu
OBJECTIVE: To explore the effect of 23.4% hypertonic saline for management of elevated intracranial pressure in children admitted to our institution for severe traumatic brain injury. DESIGN: Single-center, retrospective medical chart analysis. SETTING: A PICU at a level 1 pediatric trauma center in the United States. PATIENTS: Children admitted for severe traumatic brain injury from 2006 to 2016 who received 23.4% hypertonic saline and whose intracranial pressures were measured within 5 hours of receiving 23...
January 18, 2019: Pediatric Critical Care Medicine
Zhiwei Li, Guoliang Fan, Xiaorong Zheng, Xiaowen Gong, Tienan Chen, Xiaocheng Liu, Kegang Jia
OBJECTIVES: Our goal was to investigate risk factors for acute kidney injury (AKI) after coronary artery bypass grafting (CABG) and the impact of AKI on short-term outcomes. METHODS: Data on 1395 patients (1261 who had isolated CABG and 134 with other operations) who underwent non-emergent CABG from January 2013 to March 2016 were retrospectively collected from a single centre. Logistic regression was performed to analyse risk factors. Cox regression was used to analyse the impact of AKI on the postoperative 30-day death rate...
January 16, 2019: Interactive Cardiovascular and Thoracic Surgery
Victoria E Blanco, Carolina V Hernandorena, Paula Scibona, Waldo Belloso, Carlos G Musso
Acute kidney injury (AKI) is a common problem in hospitalized patients that is associated with significant morbid-mortality. The impact of kidney disease on the excretion of drugs eliminated by glomerular filtration and tubular secretion is well established, as well as the requirement for drug dosage adjustment in impaired kidney function patients. However, since impaired kidney function is associated with decreased activity of several hepatic and gastrointestinal drug-metabolizing enzymes and transporters, drugs doses adjustment only based on kidney alteration could be insufficient in AKI...
January 14, 2019: Healthcare (Basel, Switzerland)
Alberto Benazzo, Stefan Schwarz, Moritz Muckenhuber, Thomas Schweiger, Gabriela Muraközy, Bernhard Moser, José Matilla Sigüenza, György Lang, Shahrokh Taghavi, Walter Klepetko, Konrad Hoetzenecker, Peter Jaksch, Cristopher Lambers
QUESTION ADDRESSED BY THE STUDY: The value of induction therapy in lung transplantation is controversial. According to the ISHLT, only about 50% of patients transplanted within the last 10 years received induction therapy. We reviewed our institutional experience to investigate the impact of induction therapy on short- and long-term outcomes. MATERIALS/PATIENTS AND METHODS: Between 2007 and 2015, 446 patients with a complete follow-up were included in this retrospective analysis...
2019: PloS One
Nara Thaisa Tenório Martins Braga, Adriana Banhos Carneiro, Kathia Liliane da Cunha Ribeiro Zuntini, Flávio Bezerra de Araújo, Elizabeth De Francesco Daher
Takayasu arteritis (TA) is a chronic granulomatous inflammatory condition of unknown cause that involves large vessels - particularly the aorta and its branches - such as the carotid, coronary, pulmonary, and renal arteries. The left subclavian artery is the most frequently involved vessel. Stenosis of the renal artery has been reported in 23-31% of the cases and may result in malignant hypertension, ischemic renal disease, decompensated heart failure, and premature death. Involvement of both renal arteries is uncommon...
January 10, 2019: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Tomohiko Yamamoto, Shin-Ichiro Miura, Kazuyuki Shirai, Hidenori Urata
Background: While reduction of accumulated body fluid using loop diuretics is a commonly used therapeutic option for acute heart failure (AHF), some patients, especially those with chronic kidney disease (CKD), show significantly poor treatment response to loop diuretics. Tolvaptan (TLV) has shown effectiveness against AHF in several studies. We have been using TLV for AHF treatment, and it displayed favorable outcome even in patients with CKD. This study aimed to assess the therapeutic effectiveness of TLV in AHF patients...
January 2019: Journal of Clinical Medicine Research
Emily-Ann Butler, Murray Baron, Agnes B Fogo, Tracy Frech, Cybele Ghossein, Eric Hachulla, Sabrina Hoa, Sindhu R Johnson, Dinesh Khanna, Luc Mouthon, Mandana Nikpour, Susanna Proudman, Virginia Steen, Edward Stern, John Varga, Christopher Denton, Marie Hudson
BACKGROUND: This project was undertaken to generate a core set of items to develop classification criteria for scleroderma renal crisis (SRC) using consensus methodology. METHODS: An international, multidisciplinary panel of experts was invited to participate in a 3-round Delphi exercise developed using a survey based on items identified by a scoping review. In Round 1, participants were asked to identify omissions and clarify ambiguities regarding the items in the survey...
January 7, 2019: Arthritis & Rheumatology
Francesca Zanoni, Carlo Alfieri, Gabriella Moroni, Patrizia Passerini, Anna Regalia, Maria Meneghini, Piergiorgio Messa
West Nile virus infection is more frequently associated with neuroinvasive disease and high morbidity and mortality in immunocompromised hosts. Here, we describe a 47-year-old Egyptian kidney transplant recipient who was admitted to our department in 2016 for persistent fever, altered mental status, and upper limb tremors. In addition, renal impairment, signs of acute thrombotic microangiopathy, pancreatitis, and slightly altered inflammatory indices were present. The patient was treated with antibacterial and antiviral therapy, and reduced immunosuppressive therapy was prescribed...
December 31, 2018: Experimental and Clinical Transplantation
Filiz Markfeld-Erol, Juliane Farthmann, Johannes Donauer, Mirjam Kunze
HISTORY AND CLINICAL FINDINGS:  We report of three pregnancies, two with renal insufficiency and one with a history of renal transplantation. Pat.1 is a 32y at 20 weeks of gestation with acute renal failure, nephrotic syndrome and history of familial Mediterranean fever. Case 2 is a 23y with cirrhotic kidneys, stage 5 of chronic kidney disease and dialysis treatment 3 × a week. The pregnancy was an incidental finding. Pat. 3 is a 29y I/0 with history of renal transplantation years ago...
January 2019: Deutsche Medizinische Wochenschrift
Jacob Weber, Ali Olyaei, Joseph Shatzel
Direct oral anticoagulants (DOACs) have been shown to be superior to vitamin K antagonists (VKAs) in regards to safety and efficacy in numerous clinical trials, and are now the preferred oral anticoagulant by multiple professional societies. However, patients with significant levels of organ dysfunction were excluded from all major clinical trials, leaving the clinical benefit in these subsets uncertain. Patients with chronic kidney disease (CKD) specifically often require anticoagulation for acute or long-term indications such as venous thromboembolism, atrial fibrillation, or mechanical heart valves...
December 28, 2018: European Journal of Haematology
Elena Zakharova
Background: The anatomy and physiology of kidneys as well as kidney diseases have been studied in Russia since the 18th century. However, there was a surge in interest in the 1920s, with numerous researchers and clinicians making substantial advances in the understanding of the pathophysiology, pathology, and diagnostics of kidney diseases. The field of nephrology as clinical practice can be traced back to 1957-1958, when the first beds for patients with kidney diseases became available and the first hemodialysis procedure was performed...
November 2018: Kidney Diseases
Arata Hagikura, Kenji Goto, Hideo Takebayashi, Yuetsu Kikuta, Kazunari Kobayashi, Katsumasa Sato, Masahito Taniguchi, Shigeki Hiramatsu, Yu Kawai, Hiroaki Kohno, Takanori Kusuyama, Seiichi Haruta
Background Persistent renal damage (RD) three months after exposure to contrast media is associated with contrast-induced acute kidney injury (CI-AKI) and poor clinical outcomes. Little is known about the role of preprocedural hydration on persistent renal damage (RD) in patients with chronic kidney disease (CKD; estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m2 ) undergoing percutaneous coronary intervention (PCI). We therefore examined the use of preprocedural hydration to decrease the incidence of persistent RD...
December 18, 2018: Internal Medicine
Juan Gustavo Vázquez-Rodríguez, Dulce Yadira Barboza-Alatorre
Background: In severe preeclampsia (SP), pregnancy interruption is the first recommendation. However, some patients receive expectant treatment. Objetive: To determine maternal and perinatal results of expectant treatment of SP in the intensive care unit (ICU) of a high-specialty hospital. Methods: Observational, descriptive and retrospective study; the files of 40 pregnant patients with SP managed in the ICU with expectant treatment were reviewed...
November 30, 2018: Revista Médica del Instituto Mexicano del Seguro Social
Jesmar Buttigieg, Hatem Ali, Ajay Sharma, Ahmed Halawa
The presence of pre-formed donor-specific antibodies (DSAs) in kidney transplantation is associated with worse overall outcomes compared with DSA-negative transplantation. A positive complement-dependant cytotoxic crossmatch presents a high immunological risk, while a negative flow cytometry crossmatch is at the lower end of the risk spectrum. Yet, the presence of low-level DSA detected by Luminex alone, that is, positive Luminex and negative flow (PLNF) cytometry crossmatch lacks robust scientific exploration...
November 30, 2018: Nephrology, Dialysis, Transplantation
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